Pilot results of a telemedicine social franchise in rural Kenya: Evidence of sustainable livelihood creation

Mashavu: Networked Health Solutions increases access to pre-primary health services, provides personal health information tracking, and income-generation opportunities to women in rural Kenya. The aim of this paper is to explore the potential of Mashavu, a healthcare social franchise, to create sustainable livelihoods for its employees in rural Kenya. The research team conducted two pilots of the Mashavu system in a rural Kenyan community. While the initial pilot protected Mashavu Health Workers (MHWs) from the financial risks of taking a new service to the market, the second pilot removed employee income subsidies. The removal of subsidies after the conclusion of the first pilot led to a divergence in monthly wages for the MHWs. While one MHW retained consistent monthly income by increasing the number of days worked monthly and the number of clients seen, a second MHW retained a largely consistent schedule without significantly increasing the number of clients daily and experienced a 600 KSH (29%) decrease in monthly wages. Following a period of employee incubation from financial risk, the MHWs consistently involved in the program were able to continue to generate income through Mashavu.